Shakespeare Walk in Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed and assessed people’s care, and when required referred or signposted patients to other services to achieve this. At the last inspection the service was found to be in breach of Regulations 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including concerns related to ineffective communication with staff, poor access to guidance and information, and poor locum staff induction processes. At this assessment we found that these issues had been addressed. For example, communication with staff had been improved through the use of a staff engagement platform and daily meetings, and staff had access to guidance and information. Staff induction, which included locum/agency staff induction had been improved and was comprehensive.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, wellbeing, and communication needs with them. All patients were triaged prior to treatment to assess their needs. Walk in centre patients were triaged on entry to the service, and those who had received NHS 111 booked appointments had triage undertaken remotely. All staff had been trained how to identify deteriorating patients, including children, and knew actions to take in this event. Clinical staff used appropriate tools to assess need such as NEWS2 (National Early Warning Score, a system used to identify acutely ill people), and POPS (Paediatric Observation Priority Score, used to identify the range of severity of childhood illness). Reception staff told us that on booking in they looked to identify any other specific needs, such as the requirement for an interpreter.If a patient’s needs could not be met by the service, they were either given advice on how to manage their condition, or signposted or referred to a more appropriate provider.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. The provider had systems and processes to keep clinicians up to date with current evidence-based practice. Our review of patient records showed that patients were being effectively and safely managed in line with guidance. The provider told us that new guidance was discussed at the organisation’s monthly clinical leads meeting. Information regarding guidance was cascaded to relevant staff via daily mini-briefings (huddles) and via emails. The provider used clinical supervision sessions and clinical audits to assure themselves that guidance was being followed. When concerns were identified with staff regarding their performance, staff were informed of this and supported to improve.

The service worked across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. For example, NHS 111 patient triage details were available to clinicians and used to aid assessment and treatment. The practice worked with other services to ensure continuity of care, this included local hospital services, and local primary care networks.

Staff told us that they were committed to promoting and encouraging patients to live healthier lives. However, as a walk-in centre the service had only limited opportunities to improve overall patient health and wellbeing, as the main focus was to treat the condition the patient had presented with. Notwithstanding this, if during triage and treatment the service identified patients who required additional support they would advise and signpost them to other services which could help them to manage their health and wellbeing. For example, they had access to a local directory of services, such as weight management, stopping smoking, and community mental health services.

The service monitored elements of people’s care and treatment to continuously improve it. Staff ensured that treatment decisions were sound and consistent, and that they met both clinical expectations, and when possible the expectations of people themselves. For example, the provider audited decisions made by clinicians in relation to patient treatment and prescribing. Due to the nature of the service, there was not an expectation that the provider followed up patients after they had received treatment at the walk in centre. Notwithstanding this, the provider undertook monitoring of key performance indicators linked to their contract. Performance was good over a number of areas, and was predominantly in line with targets. For example, from January to the end of March 2025 the service met it’s 4-hour target for patients to be seen, referred or discharged following presentation. The target for this was 95% and the service had achieved averages of between 95.6% and 99.3%. To give an indication of throughput between April 2024 and the end of March 2025 the service had seen 48,594 patients (an average of 134 per day). However, we saw that on occasion the service had failed to achieve their target to triage walk in patients within 15 minutes of entry. They told us that this was challenging at certain times due to staff needing to take required breaks which limited capacity, and also because the service had no control over when patients arrived at the walk in centre, so could be subject to a large influx at any one time. The service had mixed performance for their target for patients leaving the walk in centre without being seen. In January and February 2025, they had met the target of keeping this below 3%, but in March 2025 this had risen to 3.84%. To mitigate this, and improve performance going forward, the provider had increased staffing levels. They also worked with patients on booking in to improve their understanding of the care pathway, and therefore better manage their expectations. The provider reported performance to the service commissioner on a regular basis, and when they highlighted any areas of concern discussed these both internally as an organisation, and with the commissioner.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. The provider had developed protocols and procedures in relation to consent. When we spoke with staff it was apparent that they understood and applied legislation relating to consent appropriately. Staff assessed the patient’s capacity to make a decision, and all staff who required this had received mental health capacity training to support this. If needed, interpretation services were available to support effective communication around consent.